Efficacy and safety of treatment with or without pertuzumab for HER2-positive breast cancer: A meta-analysis

We conducted a meta-analysis to systematically evaluate the efficacy and safety of treatment with or without pertuzumab for human epidermal growth factor receptor-2 -positive (HER2)-positive breast cancer and provided evidence-based reference for clinical use.The Cochrane Library, PubMed, EMbase, Clinical Trials and Web of Science databases were searched for studies published up to July 2022, which reported clinical randomized controlled trials of treatment in combination with pertuzumab (experimental group) and without pertuzumab (control group) for HER2-positive breast cancer. Meta-analysis was performed using R 4.2.1 based on the extraction of the data and the risk of bias assessment under the supervision of the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0.The results from this study showed that, the patients in the experimental group showed prolonged progression-free survival [hazard ratio = 0.72, 95% confidence interval (CI) (0.65,0.80), P < .01] and overall survival [hazard ratio = 0.80, 95% CI (0.66,0.96), P = .02] than those in the control group. In terms of safety, the incidence of grade ≥ 3 adverse events including diarrhea [risk ratio (RR) = 2.36, 95% CI (1.98,2.81), P < .01] and anemia [RR = 1.43, 95% CI (1.17,1.75), P < .01] in the experimental group were significantly higher than those in the control group. The incidence of common adverse events, that is rash in the experimental group was significantly higher than that in the control group [RR = 1.62, 95% CI (1.38,1.90), P < .01].These results support that the treatment in combination with pertuzumab is superior to the treatment in combination without pertuzumab in the treatment of HER2-positive breast cancer, but there are some adverse effects such as diarrhea, anemia, and rash, which should be carefully monitored in clinical practice.